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Pg 4 eRx Consent ePrescribing is a federally mandated initiative that requires all physicians to prescribe medications electronically beginning in 2011. Hometown Pediatrics 1020 Jamestown Blvd Bldg. 200 Watkinsville GA 30677 Phone 706-769-0005 Fax 706-769-0403 Please Fill Out Completely Please Circle Your Physician Sprayberry / Kelly / Chappell / Esho New Patient Paperwork-Minor Patient s Last Name Social Security Number First Name Date of Birth Age Gender Race Ethnicity Latino Address Street...

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